A Psychiatrist’s Insight Into Psychiatry and Current Events

According to a study published November 22nd in the New England Journal of Medicine by Paul Lichtenstein, Ph.D et al, “The use of medication to treat attention-deficit/hyperactivity disorder [AD/HD] is linked to a lower likelihood of crime,” “Using Swedish national registers, researchers studied about 16,000 men and 10,000 women ages 15 and older who had been diagnosed with AD/HD.” Next, “court and prison records were used to track convictions from 2006 through 2009 and see whether patients were taking AD/HD drugs when their crimes were committed.” The results showed that as compared with nonmedication periods, among patients receiving ADHD medication, there was a significant reduction of 32% in the criminality rate for men ) and 41% for women.

Reuters (10/26, Pittman) reports that according to a meta analysis of 64 studies published in the journal Addiction, the medications naltrexone (Revia) and acamprosate (Campral) may be good initial treatments of alcoholism. Both acamprosate and naltrexone tended to work better when patients had abstained from alcohol for at least a few days before starting the medications, or had been through a detox program. Acamprosate is known to calm brain activity, so it can stabilize a brain that gets agitated when an alcoholic stops drinking. Naltrexone, works on the brain’s reward and reinforcement system, so if people were to drink while on the drug, it would block some of the positive feelings produced by alcohol and keep them from overdoing it.

The NPR (10/5, Hamilton) “Shots” blog reports that “scientists say they have figured out how an experimental drug called ketamine is able to relieve major depression in hours instead of weeks.” Ketamine is an FDA-approved anesthetic. It’s also a popular club drug that can produce out-of-body experiences and hallucinations. Not exactly what you’d want from a depression drug. “It’s exciting,” says Ron Duman, a a psychiatarist and neurobiologist at Yale University. “The hope is that this new information about ketamine is really going to provide a whole array of new targets that can be developed that ultimately provide a much better way of treating depression.” In stressed mice, a dose of ketamine was able to “rapidly increase connections and also to rapidly reverse the deficits that are caused by stress,” Duman says. Research is intended to produce drugs that will work like ketamine, but without the hallucinations. Several of these alternative drugs are already being tried in people.

According to an article in the WSJ , Melinda Beck states that many people are using omega-3 supplements to protect against various ailments, despite the fact that research on omega-3’s benefits is mixed. Recent research published in JAMA suggests that omega-3 fatty acids do not protect against heart attacks, strokes or deaths. Some medical associations, including the American Psychiatric Association, recommend regular consumption of fish rich in omega-3 for most people. Still, according to Paul Coates, director of the Office of Dietary Supplements, “There is no single answer here.” Coates adds, “Given that there is a potential for benefit, and the harm has not yet been fully explored, at reasonable levels of intake, it’s not a bad idea.”

According to a study in the August issue of the Journal of Clinical Psychiatry “A cohort study of 84 adults from Sweden showed that those who had been infected with T gondii were seven times more likely to participate in nonfatal, self-directed violence compared with their counterparts who had not been infected.” T gondii has always been known to be dangerous espically in pregnant women. It is the causative agent in Toxoplamosis. It is frequently contracted through eating undercooked meat or comin into contact with cat feces.

HealthDay (1/25, Preidt, http://tinyurl.com/minful-change) reported that a mindfulness meditation training program can trigger measurable changes in brain areas associated with awareness, empathy and sense of self within eight weeks according to a new study . Mindfulness focuses on nonjudgmental awareness of one’s feelings, sensations and state of mind, which often results in greater peacefulness and relaxation, the researchers explained. They used MRI to assess the brain structure of 16 volunteers two weeks before and after they took the eight-week Mindfulness-Based Stress Reduction program at the University of Massachusetts Center for Mindfulness. The program included weekly meetings to practice mindfulness meditation and audio recordings for guided meditation practice. The researchers also analyzed MRI scans of a control group of people who did not meditate for comparison. The meditation group participants spent an average of 27 minutes a day doing mindfulness meditation exercises. The MRI scans taken after the eight-week program revealed increased gray matter density in the hippocampus (important for learning and memory) and in structures associated with compassion and self-awareness. The investigators also found that participant-reported reductions in stress were associated with decreased gray matter density in the amygdala, which plays a role in anxiety and stress. None of these brain structure changes were seen in the control group. The study will be published in the Jan. 30 issue of the journal Psychiatry Research: Neuroimaging.

WebMD (10/8, Boyles, http://tinyurl.com/lowt-alzheimers) reported that low testosterone levels in older men with memory problems may signal progression to Alzheimer’s disease or increase the risk for developing age-related dementia. In a newly published study, older Chinese men with early memory declines who did not yet have Alzheimer’s were far more likely to develop Alzheimer’s over a year of follow-up if they had low testosterone. The study was small, but the findings suggest low testosterone may be an independent risk factor for rapid cognitive decline in older men with early memory loss, according to Saint Louis University Medical Center professor of gerontology John Morley, MD . All the men underwent testing to assess memory function at enrollment, and 47 were determined to have evidence of mild cognitive impairment. Over the course of the next year, 10 men received a diagnosis of Alzheimer’s disease. All were in the previously identified group with early memory declines and all had low levels of free testosterone in blood samples. While the research suggests a role for testosterone in the prevention of Alzheimer’s disease, study researcher Scott Moffat, PhD, says it is too soon to recommend testosterone treatment for men at risk for cognitive decline. “It is not really clear if testosterone is protecting the men in these studies or if levels are reflective of some other factor, such as overall better health,” he tells WebMD.

About the author

Adam Brandemihl, M.D., D.A.B.P.N. is a board certified psychiatrist in Dublin, Ohio. He treats adult patients and older teenagers with diagnoses ranging from ADHD, to anxiety and mood disorders. He was trained at The Ohio State University and is an avid sports fan. Appointments are generally available within one to two weeks by calling 614-766-5205. Learn more atBuckeye Psychiatry, LLC.